Tanjala S. Purnell is a second-year Ph.D. student in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and a research trainee at the Johns Hopkins Welch Center for Prevention, Epidemiology, and Clinical Research. She seeks this National Research Service Award (NRSA) Training Grant to support her career development with the goal of becoming a successful independent clinical researcher studying ways to address ethnic/racial health disparities for patients with chronic kidney disease. During this award, Ms. Purnell will pursue rigorous research and didactic training in a program designed to provide a strong foundation for her future career. In her research, she will examine ethnic/racial differences in attitudes regarding economic risks of live kidney donation, determine whether ethnic/racial differences in attitudes are associated with ethnic/race differences in willingness to donate, and she will assess the impact of federal and state policy interventions addressing economic barriers to live donation upon ethnic/racial differences in live kidney donation rates. Additionally, she will assess whether access to enabling resources (including income/wealth, health insurance, and occupational prestige) explain the relation of ethnic/race differences in attitudes toward economic risks and ethnic/race differences in willingness to donate. To accomplish these aims, she will conduct cross-sectional and longitudinal studies of living kidney donation attitudes and behaviors in the United States, utilizing complex weighted survey data obtained from regional and national studies of persons in the general public and by creating a national dataset of living kidney donors utilizing publicly available data from several sources. She will employ regression analyses, multiple-time series analyses, and other longitudinal analysis techniques in these studies. Ms. Purnell's research objectives are closely aligned with the National Institute of Diabetes and Digestive and Kidney Diseases end-stage renal disease target focus of improving rates of kidney transplantation and donation, particularly by African Americans and other ethnic/racial minority groups. In her didactic program, Ms. Purnell will take advanced coursework in research methods, including advanced techniques in study design and analysis, grant writing, and research ethics. Through attendance at national meetings as well as several advanced research seminars, held in the supportive training environment at the Welch Center, she will also have the opportunity to observe the work of others and present her own work. She has identified a team of experienced faculty mentors who are committed to supporting her success and who will make sure she has the resources to assure her completion of the proposed aims of this application. PUBLIC HEALTH RELEVANCE: My primary career goal is to become a successful independent health services and policy researcher whose work directly contributes to improving health outcomes and reducing disparities in measures of access and quality for patients with chronic kidney disease. I want my future work to contribute to the implementation of federal and state policy legislation that improves health outcomes for chronic kidney disease patients and influences healthcare decision-making that will improve delivery of care for vulnerable populations. I also plan to motivate and train future health services and policy researchers by pursuing a career in academia. The Kirschstein-NRSA Fellowship Training Award will provide me with the opportunity to further develop the skills I need to pursue my research and career goals. This award will allow me to concentrate on coursework and opportunities for experiential learning that will facilitate the successful completion of my dissertation work, as well as my development as an independent health services and policy researcher. In addition to the coursework, an integral focus of my training activities during the fellowship award period will be to engage in special studies and to participate in research projects with faculty members and researchers at the Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Johns Hopkins Center for Health Disparities Solutions, and the Johns Hopkins Welch Center for Prevention, Epidemiology, and Clinical Research on projects directly related to my career goals.